Explore issues associated with teenage pregnancy

As a teenager, it's easy to enter a potentially risky situation and think, “well that could never happen to me.” And, unfortunately, many adolescents approach the subject of sex with this same mindset and become pregnant each year. For more information see Adolescence Developmental Psychology.

In the United States, nearly 72 out of 1,000 teenage girls ages 15 to 19 become pregnant each year, according to statistics from the Guttmacher Institute. Thrust into adulthood, teenagers facing unplanned pregnancies must make life-changing decisions at an age where they might be cognitively unprepared to do so.

Society as a whole agrees that teenagers are simply ill-prepared to deal with the plethora of new responsibilities and life changes associated with motherhood.

To approach this problem, researchers, social workers, and government-led groups are actively developing new programs and prevention methods to reduce the number of unintended teenage pregnancies, and provide services for pregnant teens.

Teenage Pregnancy Facts

Teen pregnancy accounts for more than $9 billion in costs to U.S. taxpayers each year. This includes increased health care and foster care costs, increased incarceration rates of children born to teenage mothers, and lost tax revenue from low-income bracket mothers.

In 2006, 750,000 women younger than 20 became pregnant.

In 2006, the teenage birthrate was 41.9 births per 1,000 girls, 32% lower than its peak of 61.8 in 1991.

In 2006, the abortion rate was 19.3 abortions per 1,000 girls, 56% lower than its peak in 1988.

From 1986-2006, the abortion rate declined from 46% to 32% of pregnancies among 15- to 19- year olds.

Sources: U.S. Centers for Disease Control and Prevention

Preventing Teenage Pregnancy

Given the high financial, emotional, and physical costs of teenage pregnancy, many are dedicated to preventing it from happening in the first place. For more information see Teen Pregnancy Prevention.

Parents must promote an open and accepting home environment for teenagers to voice their concerns in order to provide teenagers with accurate and effective sex-prevention information.

Without an open environment, a teenager might learn most of his or her sexual information from conversations with friends – information that might prove inaccurate.

Despite the awkwardness of the conversation, talking about sex with teenagers is one of the most effective ways to inform them about pregnancy and the emotional and physical consequences of sexual activity.

When the National Campaign to Prevent Teen Pregnancy polled 1,008 teenagers about sex and pregnancy, 46% said their parents influenced their decisions about sex the most, and that having conversations about sex helped them to delay sexual activity and avoid pregnancy.

Without an open environment, teenagers are at greater risk to become pregnant or contract a sexually transmitted disease. In the same poll, 63% of the teenagers agreed that the primary reason teenagers don't use contraceptives is because they fear their parents will discover that they are sexually active.

But given the normal teenage desires for freedom and independence, parents often find it difficult to start these sensitive conversations. Teenagers might seem embarrassed, uninterested, or react negatively when parents attempt to start a conversation about sex.

Fortunately most schools offer sex education programs, so even if teenagers seem uninterested in talking about sex with their parents, they still receive accurate and effective information about pregnancy prevention.

According to the American Congress of Obstetricians and Gynecologists (ACOG), more than two-thirds of public school districts have sex education policies, and 85% of those require programs to promote some form of abstinence.

Common Characteristics of Effective Sexual Education Programs

In the article, “Strategies for Adolescent Pregnancy Prevention,” ACOG lists a number of common characteristics of successful sex education programs:

Focus clearly on reducing one or more sexual behaviors that lead to unintended pregnancy;

Maintain age appropriate and culturally relevant behavior goals, teaching methods, and materials that coincide with the sexual experience level of participants;

Allow sufficient time for presentation of information and completion of assignments;

Involve the participants in order to personalize the information being presented;

Provide basic information about the risks of sexual intercourse without protection;

Address social pressures to engage in sexual activity;

Give and continually reinforce a clear message about either abstaining from sexual activity and/or using birth control during sexual intercourse.

Abstinence-only vs. Abstinence-plus

Abstinence-only programs teach abstinence until marriage. These programs focus on the negative outcomes of adolescence sexual activity, such as pregnancy and sexually transmitted diseases, but do not teach about proper contraceptive use.

Abstinence-plus programs teach students to wait until they are ready to have sex, but also include information about contraceptives and birth control in their programs.

Proponents of abstinence-only programs maintain that the only sure way to prevent pregnancy is to not have sex.

Sylvana E. Bennet and her coauthors published one of the most comprehensive studies examining the effectiveness of both abstinence-only and abstinence-plus programs in The Journal of Adolescent Health.

Results showed that none of the programs – neither abstinence-only nor abstinence-plus – resulted in decreased or increased numbers of sexual partners for the students. However, contraceptive knowledge made up the major disparity between the programs.

Teens in abstinence-only programs consistently scored lower on quizzes testing knowledge of contraceptives, while seven out of 10 abstinence-plus programs showed an improvement in contraceptive use among students.

Bennet concludes that while sex education programs might temporarily reduce sexual activity for teens, this result is often short-lived and modest. Furthermore, students in abstinence-only sex education programs were less likely to use contraceptives.

Helping Pregnant Teenagers

Despite prevention efforts, mistakes do happen, and teenagers become pregnant. These teens face serious challenges to their educational, emotional, physical, and financial states.

Fortunately, support systems do exist to help these teens make important decisions that will affect the rest of their lives.

When a teen discovers she is pregnant, dozens of new thoughts race through her mind. How will she tell her parents? Should she keep the baby? How will she afford it? What's going to happen with school?

These questions and more occupy the pregnant teen's mind, and are often overwhelming at a time when previously the teen's biggest source of stress might have been where to meet friends on a Saturday night.

Because of the overwhelming stress the young girl is experiencing, it’s extremely important for her to visit a local health care center. Here the teen will receive accurate information about the stage of pregnancy, as well as health information and counseling on her options.

Counselors, health care professionals, and social workers provide invaluable support to the teenager through this trying time, providing advice, care, and access to financial assistance.

Some teens are nervous about going to their families with the discovery of a pregnancy, and find comfort by first speaking to counselors at health clinics. A counselor provides an open and nonjudgmental environment where a teenager weighs her options and develops a plan to tell her significant others.

Many teenagers are cognitively not ready to make decisions regarding an unplanned pregnancy because the areas of her brain responsible for processing risks, rewards, and consequences have not yet fully developed. (see Teenage Rebellion). A counselor must clearly and effectively explain all of the teen's options.

The Three Options for a Teenage Mother

A teenager has three options regarding the pregnancy. She can either place the child up for adoption, terminate the pregnancy, or become a mother. For more information see Teen Pregnancy Support.

For a teenager concerned about the financial and emotional burdens of motherhood, adoption is one choice she might make. Social workers and counselors assist teenagers through the adoption process, setting up meetings between the teen and potential adoptive parents.

According to “The Impact of Adoption on Birth Parents,” from the Child Welfare Information Gateway, teenagers often feel relief when giving their children up for adoption but might also feel a sense of loss and guilt.

Counselors working with the teen must pay special attention to these feelings of loss, and must assist the teen through the grieving process. This involves affirming the teen's feelings, noting that it's normal to feel a sense of loss through the adoption process, while also encouraging the teen to continue with her life.

An adolescent who doesn't wish to experience the social stigma and added responsibilities of teen pregnancy might consider abortion.

Teenagers considering abortion must speak with counselors to gain a better understanding of the medical and mental health risks associated with abortion. A girl's family and friends often have conflicting viewpoints of abortion, with some staunchly rejecting it, and others supporting it.

According to the book, “Pregnancy and Abortion Counseling,” by Joanna Brien and Ida Fairbairn, some studies report that teens face emotional turmoil after abortions, while others dismiss it and report that girls mostly feel relief. Teenagers should be analyzed on a case-by-case basis, and if they do feel emotional turmoil, they should seek help from counselors to navigate the grieving process.

A teen who feels she cannot manage the sense of loss that comes with abortion and adoption will choose to become a mother instead. A teenager on her way to motherhood must undergo a lifestyle change, learning new skills and health habits to ensure the proper development of her baby.

The article “Adolescent Pregnancy: A Model for Intervention,” published in The Personnel and Guidance Journal, outlines the ways a counselor works with a pregnant teen, establishing a supportive environment that includes education and guidance.

According to researchers Elaine K. Miller and others, the counselor discusses fears and concerns about the pregnancy, childbirth, and motherhood with the teenager. These might include labor and delivery, financial situations, and continuing education.

At this stage in counseling, the pregnant teen often feels alone and cast out by her peers. Counselors suggest group sessions with other teenage mothers to help ease the teen's feelings of isolation. Group interaction allows the pregnant teen to draw support from other teens who find themselves in the same situation, helping build self-esteem and confidence.

The counselor will also work with the mothers about basic childcare skills, such as breastfeeding, proper cradling techniques, and interacting with the child.

A substantial number of teenage mothers drop out of high school after childbirth, so the counselor also encourages the mother to return as quickly as possible to school, or suggests alternative education programs.

A number of support programs exist for pregnant and parenting teenagers, differing by each state. For a list of some of the support programs by state. (see Teenage Pregnancy Help).

How a Teenage Mother's Health Affects the Health of Her Future Child

While a teenager must contend with the emotional and social issues associated with a teenage pregnancy, she must also be aware of her own health in relation to the child's.

Teenage pregnancies are often unplanned, and come as a surprise and a shock to the future mother. In fact, many pregnant teenagers ignore the signs that they are pregnant, because of thoughts like, “well that couldn't happen to me.”

Teenagers sometimes engage in risky behaviors, experiment with smoking and alcohol, and often don't realize they are pregnant because they lack knowledge of the signs. Because of this, they are at a much higher rate of having low birth weight babies.

Low birth weight babies weigh less than 5.5 pounds at birth, and are 40 times more likely to die within the first 28 days compared to normal birth weight babies.

According to “The Risk of Teen Mothers having Low Birth Weight Babies: Implications of Recent Medical Research for School Health Personnel,” published in The Journal of School Health, teenage girls are twice as likely to deliver low birth weight babies than adults.

Researchers Jeffrey Roth and others contend that during adolescence, the irregularity of the ovulatory cycle in teenage girls often causes them to not notice a pregnancy until the second trimester. They often mistake signs of morning sickness for the flu or a stomach bug, unaware of the child growing inside of them.

Roth states that because teenagers are still growing throughout adolescence, a pregnant teenager and her fetus often “fight” over nutrients. Additionally, some teenagers are reluctant to adhere medical advice to gain weight, because they feel self conscious about an enlarged appearance.

Pregnant teenagers must seek prenatal care as soon as possible at their local health clinic. Here they will receive nutrition advice, vitamins, exercise, and training on quitting bad habits such as cigarette smoking.

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